ADHD and narcissistic personality may share some behavioral similarities, but they’re different conditions.

Attention deficit hyperactivity disorder (ADHD) and narcissistic personality disorder (NPD) are different mental health diagnoses yet in some instances, behaviors may look similar. The cause of these behaviors, though, is very different in each condition.

On the surface, someone with a narcissistic personality may behave in similar ways to someone with ADHD, but for different reasons.

If you live with ADHD, you may have difficulty concentrating, focusing on tasks, interacting with others, and being organized in your work. This can be due to deficits in executive functioning.

As a result, you may be unable to focus during a conversation, interrupt others, or tend to intrude on others without intending or realizing the impact of these behaviors.

People with NPD also experience interpersonal difficulties but mainly because they often demand attention and admiration from others. They may have low empathy and be unwilling to validate or acknowledge the emotions of others.

Individuals with ADHD may appear self-centered in conversations because of difficulties with concentration, whereas individuals with NPD may act in self-centered ways because symptoms include an inflated sense of self and disregard for others.

Neither ADHD nor NPD is a personal choice.

ADHD is a neurodevelopmental disorder commonly diagnosed in childhood. Symptoms typically persist into adulthood.

Narcissistic traits can emerge in adolescence but NPD is a personality disorder that isn’t typically diagnosed before age 18.

Both ADHD and NPD can impact the way you see yourself, others, and the world in general. Symptoms, however, tend to be different for both conditions.

Symptoms of ADHD

Not everyone with ADHD experiences it in the same way. Symptoms can be mild or severe.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), there are three types of ADHD:

  • inattentive ADHD: Main symptoms include difficulty paying attention, becoming easily distracted, experiencing challenges with memory, misplacing things, and starting tasks but having trouble finishing them.
  • hyperactive-impulsive ADHD: Symptoms include low impulse control and hyperactivity. For example, persistent fidgeting, restlessness, impatience, inability to sit still, and excessive talkativeness. Inattention isn’t a dominant symptom in this type of ADHD.
  • combined ADHD: This type includes both inattention and hyperactivity-impulsivity symptoms.

ADHD symptoms can exist on a spectrum, but receiving a diagnosis typically implies that your symptoms significantly impact your social and cognitive functioning.

Symptoms of narcissistic personality disorder

The traits of narcissism can include a lack of empathy, arrogance, self-centeredness, grandiosity, and entitlement. These traits can be common in adolescence, exist on a spectrum, and don’t necessarily mean you will develop narcissistic personality disorder.

When these traits cause great distress to yourself and others, though, they may lead to receiving a formal diagnosis.

The formal symptoms of NPD, according to the DSM-5, are:

  1. a grandiose sense of self-importance
  2. preoccupation with unlimited success, power, or beauty
  3. a sense of superiority to others and attempts to associate with other “special” people
  4. the expectation of constant admiration, attention, and praise
  5. a persistent sense of entitlement
  6. tendency to use manipulation tactics for their own gain
  7. low empathy that leads to unwillingness or inability to recognize the experiences, emotions, and needs of others
  8. envy and jealousy of others and the belief it’s mutual
  9. displays of pretentious, arrogant, and condescending behaviors

These symptoms are usually evident across different situations and over time.

Empathy in ADHD and NPD

Low empathy is a formal symptom of narcissistic personality disorder while it isn’t a characteristic feature of ADHD.

Someone with NPD may be able to develop cognitive empathy, the ability to identify the emotional states of others. However, the ability to experience emotional and compassionate empathy may be challenged. This is the ability to feel what others feel and react appropriately to their needs.

Some evidence suggests that people with ADHD may also sometimes have difficulties with empathy.

In a recent 2021 study, researchers found that children with ADHD rated lower in measures of cognitive empathy than their peers in the control group. In other words, children with ADHD had a difficult time recognizing other people’s feelings or considering their perspectives.

Another small study with adolescents also found that those with ADHD scored significantly lower in cognitive empathy and understanding someone else’s perspective. Results didn’t indicate any impairments related to emotional empathy, though.

MRI testing in the same study further revealed that no brain region was activated or related to empathy in the ADHD group, while this wasn’t the case for adolescents in the control group. Study authors suggested this may have to do with ADHD being a neurodevelopmental disorder that affects brain structure.

Differences and similarities in causes of ADHD and NPD aren’t well established yet.

Research indicates that when it comes to causes, ADHD may have a stronger genetic component. A 2016 study, for example, showed that 51% of fathers and 41.3% of mothers of children with ADHD had the disorder themselves.

Psychosocial factors such as strict parenting styles may also contribute to ADHD symptoms, according to a small Turkish study. More research on this link may be needed.

On the other hand, research from 2015 suggests that narcissistic traits can be fostered by overvaluation and excessive praise during childhood.

A 2020 study on parental styles and maltreatment also indicates that remembered parental overprotection, overvaluation, and leniency can be strong contributing factors in young people with diagnosable narcissistic traits.

Treatments for ADHD usually include a combination of behavior modification therapy, medication, and parent coaching in behavior treatment for children and adolescents.

Medications for ADHD might include stimulants that increase activity in brain areas that impact inattentive and impulsive behaviors.

In general, ADHD can be treated and in most instances, symptoms can be managed with success.

When it comes to NPD, treatment might be more challenging.

People with narcissistic personality disorder may not be aware or accept their behaviors can be problematic and distressing. This may lead them to not ask for help or change their behavioral patterns.

As a result, someone with NPD won’t usually seek treatment.

If they do, interventions like cognitive behavioral therapy (CBT) and schema therapy may help them identify unhealthy thinking patterns and behaviors, and some change can be experienced.

Although aggression and violence aren’t formal symptoms of either ADHD or NPD, some people with these disorders may sometimes exhibit this type of behavior.

A 2021 review of 437 studies reveals a strong link between narcissism and aggression, especially as a response to provocation, but even in its absence. This may explain why some people with NPD tend to engage in vindictive behaviors.

Individuals with NPD don’t typically experience deficits in executive functioning as those with ADHD. In other words, the condition doesn’t seem to impair memory or concentration or alter brain structure.

Research, however, indicates people with NPD may react aggressively when the “social pain network” in their brains is activated during times of perceived social exclusion and rejection.

This hypersensitivity to perceived affronts seems to contribute to their interpersonal conflicts and some of their symptoms, including narcissistic rage.

Vindictive behaviors are much less likely in people with ADHD, but a lack of impulse control may lead to seemingly aggressive behavior in some people.

For example, if you live with symptoms of hyperactivity and impulsivity, you could have difficulty “waiting for your turn” and get highly irritated and confrontational.

Someone with NPD may also have difficulty “waiting for their turn” but as a result of their sense of entitlement and persistent belief that they deserve special treatment.

Yes. Research indicates that ADHD and NPD can co-occur and often do.

Longitudinal research also indicates that childhood ADHD may increase the chance of someone developing a personality disorder, including NPD.

While this link isn’t well understood, it’s possible that some parenting styles adopted in response to a child living with ADHD could impact thought and behavioral patterns that later may lead to NPD.

ADHD and NPD are two different disorders that sometimes can co-occur.

While NPD is a personality disorder and ADHD is a neurodevelopmental disorder, they may, for different reasons, share central features like lower levels of empathy and interpersonal difficulties.

Narcissistic personality disorder is typically characterized by grandiosity, a sense of entitlement, and disregard for other people’s needs. Symptoms of ADHD, on the other hand, usually include difficulty focusing, impulsivity, restlessness, and memory challenges.

Neither of these conditions is a personal choice and symptoms of both can be managed, although people with NPD tend to lack insight into their need for professional support.


Shahida Arabi, MA, is a summa cum laude graduate of Columbia University and best-selling author of three books, including “Becoming the Narcissist’s Nightmare and Power.” Her new book, “The Highly Sensitive Person’s Guide to Toxic People,” published by New Harbinger Publications, is available in all major bookstores. Her viral articles have garnered over 18 million views and her work has been featured on Psychology Today, Salon, Bustle, Psych Central, The Huffington Post, Inc., Origin, Thought Catalog, VICE, and The New York Daily News. She’s currently a graduate student at Harvard University conducting research on romantic relationships with individuals with narcissistic and psychopathic traits.